Tycel Phillips, MD, MPH, associate clinical professor, Division of Lymphoma, Department of Hematology & Hematopoietic Cell Transplantation, City of Hope, discusses the use of bispecific antibodies and CAR T-cell therapy across hematologic malignancies, including in patients with mantle cell lymphoma (MCL) and follicular lymphoma (FL).

There are several bispecific antibodies under investigation across the hematologic malignancy landscape, Phillips begins. For example, a phase 3 study with glofitamab-gxbm (Columvi) vs standard-of-care chemotherapy is launching in adult patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL), Phillips says, and accrual to this trial may begin soon. Notably, 

 in DLBCL not otherwise specified or large B-cell lymphoma arising from FL following at least 2 lines of systemic therapy. Additionally, the bispecific antibody mosunetuzumab was evaluated in the phase 2 GO29781 study (NCT02500407) that 

 with the agent when given for a fixed duration in patients with relapsed/refractory FL, Phillips explains.

The bispecific antibodies epcoritamab-bysp (Epkinly) and odronextamab do not yet have substantial data in LBCL and DLBCL, respectively, Phillips expands, adding that preliminary data with these agents will show their efficacy. Based on historical data with blinatumomab (Blincyto) in B-cell malignancies, Phillips suspects that epcoritamab and odronextamab will also be effective in this population. However, the safety profiles of these agents may be less favorable, Phillips notes. Bispecific antibodies have different safety profiles in patients with MCL than in those with NHL, making it important to wait and see how the data with these bispecific antibodies play out, he emphasizes. Furthermore, there is an ongoing study in high-risk patients with MCL evaluating the upfront use of glofitamab, he continues.

Regarding CAR T-cell therapy, the early phase 1 Window-3 study (NCT05495464), which is open for accrual at the University of Texas MD Anderson Cancer Center, will investigate first-line CAR T-cell therapy in patients with high-risk MCL, Phillips says. Patients with high-risk MCL have a high level of unmet need, making these ongoing trials vital, Phillips concludes.

Videos

Tycel Phillips, MD, MPH, discusses the use of bispecific antibodies and CAR T-cell therapy across hematologic malignancies, including in patients with mantle cell lymphoma and follicular lymphoma.


Dr Phillips on the Use of Bispecific Antibodies and CAR T-Cell Therapy in MCL and FL

Tycel Jovelle Phillips, MD, clinical associate professor, the Division of Hematology and Oncology, the Rogel Cancer Center, Michigan Medicine, University of Michigan Health, discusses the role of 

 mutations in the outcomes of patients with mantle cell lymphoma (MCL).

 mutation tend to have worse outcomes than those without this mutation, as there is currently no defined treatment approach for this disease subset, Phillips says. The p53 gene is a tumor suppressor that can be affected through deletions or mutations, Phillips explains.

Since there are 2 copies of the p53 gene, 

 deletion, when chromosome 17p is lost, is often not as detrimental as a 

 mutation, since a patient may have another functional copy of the gene, Phillips notes. If 1 copy of the p53 gene is mutated, however, it will deactivate the other copy, and the patient will lose all p53 function, Phillips concludes.

Tycel Jovelle Phillips, MD, discusses the role of p53 mutations in the outcomes of patients with mantle cell lymphoma.

Tycel Jovelle Phillips, MD

Articles

Dr Phillips on the Use of Bispecific Antibodies and CAR T-Cell Therapy in MCL and FL

Dr. Phillips on p53 Mutations in MCL